With Dementia Diagnosis, Knowledge Is Power: Anxiety and Depression Levels May Go Down after Diagnosis Is Disclosed to Patients and Caregivers
Johnson, Kate, Clinical Psychiatry News
ORLANDO -- Contrary to many physicians' fears, disclosing a diagnosis of dementia to patients and their caregivers does not produce negative reactions, and in some cases actually lowers their anxiety and depression levels, according to a survey.
The findings should encourage physicians to be more up front when faced with reporting such a diagnosis, said the study's lead investigator Brian D. Carpenter, Ph.D., of the department of psychology at Washington University, St. Louis.
In a review paper, Dr. Carpenter's team reported that reluctance to disclose a dementia diagnosis is common among physicians (Gerontologist 2004;44:149-58).
"On average, somewhere around 50% of physicians say they don't routinely tell patients and caregivers when there is a diagnosis of dementia because they are worried about an extremely negative, even suicidal, reaction," he said in an interview. "They just tell them it's normal aging."
But in his study, which he presented as a poster at the annual meeting of the Gerontological Society of America, Dr. Carpenter found that, among 80 patient-caregiver dyads, initial reactions within 3 days of a diagnosis of dementia were not negative--even among those who did not expect such a diagnosis.
The longitudinal study recruited patients and their caregivers at the time of their initial contact with the Washington University Alzheimer's Disease Research Center. Surveys assessing baseline data on self-reported anxiety and depression were mailed to all subjects as soon as their initial appointment was scheduled. Similar surveys were then obtained by telephone 2-3 days after a diagnosis had been given.
Depression was measured using the Geriatric Depression Scale, and anxiety was measured using the State-Trait Anxiety Inventory. Participants were also asked about their diagnostic expectations in the first survey.
In total, 67% of patients were diagnosed with dementia (21% with mild dementia and 46% with very mild dementia), and the remaining 33% had no dementia.
Regarding diagnostic expectations, caregivers were more accurate than patients when estimating the likelihood of a dementia diagnosis. More than half (52%) were correct when they said they expected a dementia diagnosis, compared with 32% of patients. …